Background Evidence from longitudinal studies has shown that stressful work and family situations are linked to chronic inflammation and altered cortisol profiles, both of which are risk factors for later disease. Conversely stable partnerships and work are known to be beneficial for health. However, few studies have previously investigated whether combined histories of work, partnerships and parenthood are related to later health, and in particular to markers of stress. The aim of this study was to investigate associations between work-family life courses (work, partnerships and parenthood) and biomarkers of inflammation and stress in mid-life amongst British men and women. Gender differences in these associations were also explored.
Methods Multiply-imputed data on almost 6500 participants of the National Child Development Study 1958 British birth cohort were used in this study. A novel method - multi-channel sequence analysis – was used to create a typology of work-family life courses between 16–42 years, combining annual information on work, partnership and parenthood. Associations between work-family life courses and inflammation (C-reactive protein (CRP), fibrinogen and von Willebrand factor (vWF)) and cortisol at age 44/45 years were tested using multivariate linear regression. Estimates are presented as percentage difference as all outcomes were positively-skewed and therefore log-transformed.
Results Compared to those who combined strong ties to paid work with later transitions to stable family lives (‘Later stable’ group), ‘Teen parents’ had higher CRP (40.6% higher, 95% CI: 5.6, 87.0) and fibrinogen (7.8% higher, 95% CI: 2.3, 13.5) levels, and ‘Homemakers’ had raised fibrinogen levels (4.7% higher, 95% CI: 0.7, 9.0), independent of childhood health and socioeconomic position, adult socioeconomic position, health behaviours and BMI. Those who combined later transitions to stable family ties with a career break for childrearing had higher post-waking cortisol (1.7% higher, 95% CI: 0.1, 3.3) than the ‘Later stable’ group. This was found to be mediated by health behaviours, particularly higher physical activity in this group. No statistically significant gender interactions in associations between work-family types and inflammatory or cortisol outcomes were found.
Conclusion Work-family life courses characterised by early parenthood or weak work ties were linked to a raised risk profile in relation to stress-related biomarkers. The findings suggest that policies which enable parents to maintain strong ties to paid work, such as affordable childcare and flexible working, are likely to improve later health.
- life course